title: [Reconstruction methods to achieve optimal postoperative bowel function following low anterior resection for rectal cancer].
abstract: After low anterior resection for rectal cancer, approximately 50% of patients experience defecatory malfunction such as multiple evacuations, urgency, and soiling. Since the neorectum is constructed with the remaining colonic segment, it can only substitute for the rectum to a limited extent. A straight anastomosis is most frequently used when the rectal remnant is sufficient, such as in high anterior resection. When the height of anastomosis is close to the anal sphincter, a J-pouch, a side-to-end, or a transverse coloplasty pouch are constructed to achieve better postoperative bowel function. The advantage of J-pouch reconstruction is not only the increased volume but also may be decreased motility when compared with straight reconstruction. In terms of postoperative function, the side-to-end and transverse coloplasty pouch have both been reported to exhibit similar functional results to J-pouch reconstruction. To obtain optimal functional results, pouch reconstruction should be considered, especially when the height of anastomosis is at the levator plane.
authors.affiliation: Department of Surgery, Teikyo University Chiba Medical Center, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Koda
authors.forename: Hideki
authors.initials: H
authors.lastname: Yasuda
authors.forename: Masato
authors.initials: M
authors.lastname: Suzuki
authors.forename: Masato
authors.initials: M
authors.lastname: Yamazaki
authors.forename: Tohru
authors.initials: T
authors.lastname: Tezuka
authors.forename: Chihiro
authors.initials: C
authors.lastname: Kosugi
authors.forename: Ryota
authors.initials: R
authors.lastname: Higuchi
authors.forename: Maki
authors.initials: M
authors.lastname: Sugimoto
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hirano
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Uemura
authors.forename: Hironori
authors.initials: H
authors.lastname: Tsuchiya
mesh_terms: D039021:Colonic Pouches; D003672:Defecation / Q000502:physiology; D006801:Humans; D012004:Rectal Neoplasms / Q000601:surgery*